Investigation On Occupational Hazardous Factors In Medical Staff

?Objective?To survey the medical personnel occupation hazard contact status and occupation health current situation;explore and analyze the main occupation factors which effect the health status of the medical staff;and provide advice for the intervention and control of occupational hazards of medical personnel.So as,to protect the physical and mental health of medical personnel.?Methods?From August to November in 2016,stratified cluster sampling was used to select 1 provincial,city and county general hospitals in Shandong Province.The clinical medical personnel,including doctors,nurses and technicians as the research object.Using a self-designed questionnaire on the health status and occupational hazard factors of medical staff,a questionnaire survey was carried out by the trained investigators.The contents of the questionnaire included general demographic characteristics;factors of contact of solid particles,chemical,physical,biological,radiological hazard factors and occupation stress;Investigation on the main symptoms and signs of the major body system.63 prescriptions were collected by convenient sampling method,and the reliability,test and acceptability evaluation were carried out.Chi square test was used to compare the incidence rate of medical staff in different occupational hazardous factors.Analysis of influencing factors of medical staff's discomfort symptoms or diseases by Logistic regression analysis.?Results? 1The basic situation of the research objectA total of 5003 subjects were included in the survey,5003 questionnaires were distributed,4512 were collected and the recovery rate was 90.2%.66 valid questionnaires were removed,4446 valid questionnaires,the effective rate was 98.5%.A total of 4446 respondents,the provincial hospital of 2175(48.9%);municipal hospital of 1497(33.7%);county hospital of 774(17.4%).1445 doctors,2216 nurses and 785 technicians.The gender distribution of the female(73.2%)was more than that of the male.Undergraduate medical education accounted for the largest(54%),followed by college education(23.2%),master's degree,doctoral degree is relatively small.Junior medical staff accounted for the largest proportion(53.9%),intermediate,subtropical high,the number of senior titles were reduced.2 Overview of occupational hazardous factors in medical staff 2.1 Solid particlesMedical personnel contact the following solid particles: talc dust,cotton dust,gypsum dust,etc.The contact rate of solid particles was highest among nurses.Talc dust should be regarded as the key point of medical workers' solid particle protection.2.2 Chemical hazardous factorsMedical personnel contact with the following chemical harmful factors: disinfectants,anesthetics,a variety of chemical agents,antibiotics and antineoplastic drugs.Medical personnel contact with the following disinfectants: chlorine disinfectant,ethanol,ammonia,ammonium hydroxide,ethylene oxide,glutaraldehyde,hexanediol and so on.The highest contact rate was chlorine disinfectant(73.1%),followed by ethanol(63.2%).Medical personnel contact anesthetic include: chloroform,ether,ethyl chloride,bilan and so on.The anesthesia surgery department accounted for only 14.8% of the total amount of narcotic medical personnel,non-anesthesia surgery medical staff anesthetic exposure rate of 85.2%.The highest rate of anesthetic exposure is the doctor,the highest rate of contact was ether(24.3%).Anesthesia surgery department,dentistry should be the focus of anesthesia occupational protection departments.Medical personnel contact with the following chemicals: mercury,formaldehyde,benzene,glacial acetic acid,anti-tumor drugs,sodium hydroxide,polyacrylamide and so on.There were the most medical staff exposed to mercury(1772),followed by formaldehyde(882)and benzene(492).The highest contact rate of mercury for the Department of burn orthopedics(70.6%);the highest contact rate of formaldehyde for the Department of Pathology(90.2%);benzene exposure rate of the highest department of the Department of Pathology(94.1%).2.3 Physical harmful factorsMedical personnel exposed to the following physical factors: noise,ultraviolet,microwave,etc.The most harmful physical hazards are noise pollution.The noise pollution exposure rate ranked the top five departments for disinfection center(78.6%),laboratory(75.9%),cardiac surgery(74.3%),intensive medicine(69.9%),neurosurgery(69.1%).2.4 Biological harmful factorsAmong the 4446 respondents,the number of medical personnel exposed to biological harmful factors was 3453 and the contact rate was 77.7%.The harmful effects of medical personnel exposure include: hepatitis B virus,HIV,hepatitis C virus,Mycobacterium tuberculosis,hepatitis A virus,Helicobacter pylori,Coxsackie virus,Brucella,Bacillus anthracis,syphilis and so on.2.5 Occupational stress and psychological factors90.2% of the medical staff felt anxious,worried,upset,of which 26% of the medical staff often feel anxious,worried,uneasy.Tense doctor-patient relationship is the main cause of occupational stress of medical staff.3 Health status and influencing factors of occupational health among medical staff 3.1 Medical personnel contact solid particlesBy chi square test,group exposure to solid particles compared with non exposed group,the incidence of related diseases have statistically significant are: allergic asthma,chronic bronchitis,recurrent oral ulcer and dermatitis.Analysis of influencing factors of main symptoms or diseases in contact with solid particles by using twoclass Logistic regression analysis.The results showed that exposure to zirconia dust and gypsum dust increased the risk of allergic asthma in contact with solid particulate matter by 3.895 times and 1.517 times respectively.Exposure to zirconia dust and cotton dust caused the contact of solid particles with chronic bronchial bronchitis Of the risk increased by 2.375 times,1.657 times;exposed cotton dust to contact solid particles of medical staff recurrent oral ulcers increased risk of 1.670 times;exposure of zirconia dust,talc dust,cotton dust to contact solid particles of medical personnel The risk of dermatitis increased by 2.088 times,1.447 times,1.337 times.3.2 Medical staff exposed to antineoplastic drugsBy chi square test,the incidence rate of anti tumor drugs exposure group and the non exposed group were statistically significant,such as: frequent cold,hair loss,headache,insomnia and so on.Logistic regression analysis was used to detect the influencing factors of antipsychotic medical staff discomfort or disease.Exposure to antineoplastic drugs for exposure to antineoplastic drugs medical staff often cold,alopecia,often headache,often insomnia,poor quality of sleep,forgetfulness,inattention and irregular menstruation factors,and exposure to anti-cancer drugs were the above discomfort the risk of symptoms or illness increased by 1.180 times,1.192 times,1.238 times,1.292 times,1.440 times,1.436 times,1.183 times and 1.261 times.3.3 Dental staffThe highest incidence of dental staff is neck pain(55.0%).In addition,the main symptoms or diseases are also manifested as chronic gastroenteritis,as well as poor quality of sleep,forgetfulness,often headache and other neurological symptoms.Logistic regression analysis showed that the maintenance of a fixed posture was an important risk factor for neck pain or discomfort in the dentist,resulting in an increase in the risk of disease onset of 2.891 times;irregular diet to the oral cavity of the medical staff chronic stomach The risk of enteritis increased by 1.687 times,overtime and feeling tired,too tired,unable to make the dentist medical staff poor sleep quality of the risk increased by 2.177 times and 1.907 times.3.4 Common symptoms and diseases of medical staff and its influencing factorsThe top ten common symptoms or disease of the medical staff is often cold,waist and back pain or discomfort,chronic gastroenteritis,neck pain or discomfort,poor sleep,forgetfulness,often weak,often have a headache,often insomnia,often dizziness.Frequent cold as an example,using chi square test and step wise regression two classification Logistic regression analysis,analysis of the influencing factors of medical personnel often have a cold,too tired,results show that fatigue and weakness(OR=1.374)and contact biological hazardous factors(OR=1.357)are important influence factors of medical personnel often catch a cold.?Conclusions?Medical staff in the course of practice exposure to a variety of occupational hazards,mainly: talc dust,formaldehyde,anti-tumor drugs,noise pollution,the relationship between doctors and patients and so on.Contact with occupational hazards to the risk of related diseases increased.The situation of medical staff occupational hazards can not be ignored.Medical staff should be treated as a special occupation and develop standards for practitioners and occupational protection.